By Dr Ananya Mandal, MD
Typhoid fever is a bacterial infection that can be successfully treated with an appropriate course of antibiotics.
If the condition is detected early, disease is usually mild and most cases can be treated with a one or two week course of antibiotics. In more serious cases, hospitalization and the intravenous administration of antibiotics may be necessary.
An outline of treatment of typhoid fever includes:
In the early stages, diagnosis may be based on clinical symptoms. In the first week of infection, laboratory tests such as the Widal test may give a false negative result due to the test's poor sensitivity and specificity.
Antibiotic treatment is therefore started on the basis of suspicious symptoms and this is called empirical treatment. Oral antibiotics usually need to be taken for a period of 7 to 14 days.
Over the years, many antibiotics that used to be effective against typhoid have now become ineffective due to the typhoid bacteria developing resistance against the drugs. For example, chloramphenicol used to be one of the most successful therapies for treating typhoid, whereas now, many strains of salmonella have become resistant to the agent in endemic regions.
Today, the most commonly used drugs in the U.S include ciprofloxacin in the case of non pregnant women and ceftriaxone for women who are pregnant or in children who may not be suitable for ciprofloxacin treatment.
To eliminate the risk of treating the infection with an ineffective antibiotic, usually an antibiotic sensitivity test is performed The antibiotics that are successful in killing the bacteria are then administered to the patient.
Usually, symptoms start to resolve within 2 to 3 days of starting the antibiotic. However, the complete course of the antibiotic needs to be taken to prevent recurrence or spread of the disease in cases where the infection has not been completely eliminated.
Aside from the use of antibiotics, home treatment should also include complete bed rest, a diet of regular and healthy meals and the intake of plenty of water.
Personal hygiene and good sanitation are important in preventing spread of typhoid fever.
In severe cases, antibiotics may need to be administered intravenously in a hospital setting. In the case of severe complications such as a ruptured intestine or severe internal bleeding, emergency surgery and other management is necessary.
Reviewed by Sally Robertson, BSc